| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $38.00 | $86.44 | $86.44 | |
Cigna
| Facility | $37.95 | $37.95 | $130.83 | |
Cigna
| Professional | $37.95 | $40.45 | $128.30 | |
Providence
| Facility | $37.95 | $79.78 | $130.83 | |
Providence
| Professional | $37.95 | $118.41 | $153.72 | |
United
| Professional | $50.66 | $52.84 | $78.61 |